Department of Obesity Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
Obes Surg. 2022 Jan;32(1):26-32. doi: 10.1007/s11695-021-05760-9. Epub 2021 Oct 29.
Weight loss before bariatric surgery is not mandatory, but questions remain as to whether preoperative weight loss has an impact on weight loss after surgery. Most studies have small sample sizes. The objective was to evaluate the relationship between preoperative and successful postoperative weight loss defined as ≥25% total weight loss (TWL) at 1 and 2 years after primary bariatric surgery with regard to the obesity-related comorbidities.
Data were extracted from a large nationwide quality registry of patients who underwent a sleeve gastrectomy (SG) or gastric bypass (GBP) between January 2015 and January 2018. Patients with completed screening and preoperative and postoperative data were included. A multivariate logistic regression analysis was performed for each technique and follow-up years separately.
In total, 8751 were included in the analysis. Patients with preoperative weight loss were more likely to achieve ≥25% postoperative TWL in both procedures. Patients with higher preoperative weight loss of 5-10% had an increased likelihood for achieving 25% TWL compared to 0-5%, OR 1.79 (CI (1.42-2.25), p < 0.001) vs 1.25 (CI (1.08-1.46), p < 0.004) for the GBP group for year 2 postoperative. This was the same for the SG group at year 2, OR 1.30 (CI (1.03-1.64), p < 0.029) vs 1.14 (CI (0.94-1.38), p < 0.198).
Patients with preoperative weight loss were more likely to achieve ≥25% postoperative TWL at 1 and 2 years after surgery in both procedures; moreover, the extent of preoperative weight loss contributes to the significance and odds of this success.
减重手术前的体重减轻并非强制性的，但仍存在疑问，即术前体重减轻是否会影响手术后的体重减轻。大多数研究的样本量较小。本研究的目的是评估与肥胖相关的合并症，在袖状胃切除术（SG）或胃旁路术（GBP）术后 1 年和 2 年，术前和成功术后体重减轻（定义为总体重减轻≥25%）之间的关系。
数据来自于一项大型全国性的患者质量登记研究，该研究纳入了 2015 年 1 月至 2018 年 1 月期间接受袖状胃切除术或胃旁路术的患者。纳入完成筛查和术前及术后数据的患者。分别对每种手术技术和随访年限进行多元逻辑回归分析。
共有 8751 例患者纳入分析。在两种手术中，术前体重减轻的患者更有可能实现术后≥25%的总体重减轻。与术前体重减轻 0-5%相比，术前体重减轻 5-10%的患者，术后 2 年实现 25%总体重减轻的可能性更高，OR 1.79（95%CI（1.42-2.25），p<0.001）和 1.25（95%CI（1.08-1.46），p<0.004），用于 GBP 组；SG 组的结果相同，OR 1.30（95%CI（1.03-1.64），p<0.029）和 1.14（95%CI（0.94-1.38），p<0.198）。
在两种手术中，术前体重减轻的患者在术后 1 年和 2 年实现≥25%的术后总体重减轻的可能性更高；此外，术前体重减轻的程度与这种成功的意义和几率有关。
